Experts say there are still ways to get the medication mailed to you.

It’s only been a little over eight weeks since the US Supreme Court overturned the landmark abortion-rights case Roe v. Wade, but people are already facing barriers to critical health care. Access to safe abortion has shifted dramatically in several parts of the country thanks to “trigger” bans that swiftly went into effect following the court’s June 24 ruling.

Banning or severely limiting abortion doesn’t actually reduce the number of people who have an abortion—it just forces them to seek out less safe options. In some states, the distance to the nearest abortion clinic is estimated to grow to hundreds of miles, per the Guttmacher Institute, a research and policy organization devoted to sexual and reproductive rights. Wait times are only expected to become longer with fewer clinics serving more people seeking out-of-state care, which poses a big issue: When you need an abortion, timing is everything.

In this scenario, abortion pills can play an especially important role. The medication can be prescribed at a clinic or via telemedicine and taken anywhere, including at home. Until at least the 10th week of pregnancy, abortion pills are an extremely safe and effective abortion method.

But people who live in a state where abortion care is out of reach may search for their own solutions online, and some may seek out abortion pills sourced from outside the established medical system, such as pills obtained without a prescription and sent through the mail from international online pharmacies, according to Kirsten Moore, director of the Expanding Medication Abortion Access Project. People who desperately need this care may decide to “self-source medication any way they can,” she tells SELF.

If you want to receive abortion pills through the mail, the least risky option is to go through a health care provider who can write you a prescription—which is why access to telehealth services will become more crucial than ever in a post-Roe world. Here’s what you need to know about booking a virtual appointment right now.

First, a little background on how medication abortion works—and what it means to “self-manage” an abortion.

The abortion pill—also known as medication abortion—requires two drugs, mifepristone and misoprostol. First, you take a mifepristone pill to block your body’s production of progesterone, a hormone needed for pregnancy. Mifepristone also softens the cervix to help the uterus empty itself. Up to two days later, you’ll take misoprostol tablets. Misoprostol causes bleeding and cramps, which empty the uterus of the pregnancy. You may need a second dose of this medication if you’re 10 or 11 weeks pregnant or a larger dose if you’re taking it without mifepristone.

You can have a medication abortion up to 70 days (or 10 weeks) after the first day of your last menstrual period, although some doctors prescribe it through the 11th week of pregnancy. If you’re further along, you’ll need to have an abortion procedure at a clinic.

Abortion pills, whether you get them in person or via telemedicine, are incredibly safe and effective. Things get slightly complicated, though, when it comes to “self-managed” abortion; this means a person chooses to have a medication abortion without going through a health care provider.

growing body of research suggests self-managed abortion “may offer a safe and effective option for those who cannot access clinical care,” per one recent study of more than 2,700 people. But the US Food and Drug Administration (FDA) doesn’t recommend choosing this route; one big reason for that is that there’s no way to know if you’ll receive a safe, FDA-approved version of the pills if you go through an unverified provider. You may also face potential legal repercussions if you are reported to the authorities for having a self-managed abortion in a state where abortion has been restricted or banned. That said, it’s crucial to recognize how many people might find themselves facing this decision for a plethora of reasons beyond their control.

If you want to get abortion pills in the mail, it’s important to understand where telehealth services stand on a state-by-state level.

Many states already make getting abortion pills via telehealth difficult to impossible: At least 10 states require abortion providers to perform ultrasounds on all patients, meaning they are required to book an in-person appointment, and at least 19 states require a doctor to be present in the room when a person takes the pills, which essentially prohibits telehealth services as an option altogether, according to the Guttmacher Institute.

Many other states, thankfully, will continue to offer medication abortion. Some people may be able to travel to these states to obtain abortion pills legally, including through telehealth—but you’ll likely need to have the virtual consultation in that state, pick up your pills or have them mailed to you in that state, and have your medication abortion in that state, depending on the provider and the area’s specific laws. (Planned ParenthoodThe Center for Reproductive Rights, and the Guttmacher Institute each offer free, interactive maps that provide detailed information on each state’s abortion laws.)

While certain states are exploring legal routes to limit or ban residents from traveling for abortions, how this might shake out or be enforced is up in the air. Currently, in states with abortion restrictions, most laws to date penalize abortion providers and not people who have abortions, Abigail R.A. Aiken, an associate professor specializing in abortion policies at the University of Texas at Austin LBJ School of Public Affairs, tells SELF.

However, Greer Donley, an assistant professor specializing in reproductive health care laws at the University Pittsburgh Law School, suspects emerging legislation might target people who get abortions, including those who use abortion pills, in states where it’s illegal, since there may not be a health care provider involved in many cases. There’s already an increase in legislation that would aim to penalize people who “aid and abet” abortions too.

“Although laws that ban performing abortions don’t authorize states to criminalize people, they can nevertheless increase the likelihood of criminalization, because restrictions and all-out bans on abortion foment stigma against people who have abortions,” Jill Adams, lawyer and executive director of reproductive justice group If/When/How, tells SELF. That gives potential rise to “more surveillance and suspicion of people who experience pregnancy loss, and also the emboldenment of law enforcement to target people whom they suspect to have acted to end a pregnancy.”

Moore suspects that some anti-abortion lawmakers will eventually try to enact laws that prohibit sending abortion pills through the mail. First-class packages mailed through the US Postal Service are protected by the Fourth Amendment and can only be opened with a search warrant if a postal inspector suspects the contents violate federal law—and abortion pills remain legal under federal law, at least for now.

People are accessing telehealth abortion services regardless of where they live.

Ultimately, accessing any type of abortion will come down to weighing individual risk as the legal landscape fluctuates state by state. “The biggest issue is going to be the fear these laws instill in people,” Elisa Wells, MPH, cofounder and codirector of Plan C, an advocacy group that researches how people are accessing abortion pills in the US, tells SELF.

If you live in a state without restrictions on medication abortion, you can get abortion pills in person from a health care provider who prescribes them. (You can find a list of providers near you at Plan C.) In those states, you can also get abortion pills mailed to you following a consultation with a health care provider through one of many US-based telehealth services, including CarafemHey JaneChoix, and Just the Pill. These providers are almost entirely asynchronous. For instance, with Hey Jane, you don’t have to schedule a phone call but, instead, fill out a medical form and consult with a practitioner using encrypted messaging. The medication usually arrives within three to four days in an unmarked envelope, but you should always confirm these details with your provider as timing may vary slightly with each service.

In states where abortion is banned or restricted, some have found possible work-arounds when it comes to telehealth. For example, certain people rent a “virtual mailbox” from a mail forwarding service (such as PostScan Mail) in a state where telehealth abortions are allowed. They then use this address on forms to get pills shipped to their homes without costly travel, Wells says. This way, you’re, at the very least still in touch with a health care provider. (Plan C offers a clear guide for this process.) “When we talk to lawyers, they say everyone appears to be complying with the regulations that pertain to them,” Wells says, adding that authorities may still find other ways to penalize people who use this strategy.

AidAccess is another telemedicine option that’s becoming popular, The New York Times reports. The Austria-based nonprofit, run by Dutch physician Rebecca Gomperts, ships abortion pills to you no matter where you live in the US (In fact, research shows the organization received more than 57,000 requests from people in all 50 states between March 2018 and March 2020.) Depending on the state you live in, consultations are done with either a doctor based in the US or a doctor based in Europe. For people who live in states that require a European doctor, the medications are shipped from a pharmacy in India. These pills typically take two to three weeks to arrive, which may be a drawback, depending on how far along you are. Under the Trump Administration, the FDA sent Aid Access a warning letter to cease operations, but the organization refused and sued the federal agency to halt further legal action; it’s unclear whether state or federal prosecutors have plans to place another cease-operations request in the future. (Again, it’s important to research your state’s abortion laws before making any decision.)

Will telehealth abortion access be enough in a post-Roe world?

While preserving access to abortion pills via telehealth is incredibly important, these pills aren’t a panacea for abortion care in a post-Roe world. Some people prefer to come into a health center or prefer an abortion procedure, which is colloquially known as a surgical abortion, Melissa Grant, the chief operating officer at the telehealth abortion provider Carafem, tells SELF. “Those options should be available,” she says.

Telehealth access is also an equity issue. Abortion bans will especially impact Black people, who are already three times more likely to die due to a pregnancy-related cause than white people. Marginalized people, including people of color and those with low incomes, also tend to have less access to quality, empathetic health care, including telemedicine. Aiken points out that communities of color are more likely to lack broadband internet access at home—and broadband is required to access telehealth services. People from these groups who end up self-managing their abortions are also more often targeted by the justice system, Wells adds.

But the fight for reproductive justice is far from over, and those entrenched in the movement still feel hopeful. “We’re diving deep into the legal issues. It’s complicated and changing quickly,” Gabriela Santana, the head of business at telehealth abortion provider Hey Jane, tells SELF. “We want to push boundaries in a way that’s still legal and protects prescribers and patients.”

For many, there are ways to access abortion via telehealth, should you determine that that is the best option for you. Advocates are deeply aware of the ongoing legal limbo and, as Grant says, “Abortion providers are extraordinarily resilient.” They’re here to help you get what you need—so don’t hesitate to reach out for support, because you’re not alone in this.